CANCER INCIDENCE IN NEW JERSEY BY COUNTY, 1996-2000

for the Comprehensive Cancer Control PlanCounty Needs Assessments

August 2003

Prepared by: Cancer Surveillance Program Cancer Epidemiology Services New Jersey Department of Health &

Senior Services

New Jersey State Cancer RegistryBackground

established by legislation – NJSA 26:2-104 et.seq.

a central cancer registry (i.e. population-based incidence registry)

all cases of cancer diagnosed October 1978 to the present (about 40,000 a year)

except cervical cancer in situ diagnosed after 1994 and certain skin carcinomas

hospitals, clinical laboratories, physicians, dentists must report cases

reporting agreements with New York, Delaware, Pennsylvania, Florida, Maryland, North Carolina

New Jersey State Cancer Registry Background (cont.)

includes identifiers, demographic characteristics, medical information, vital status for each case

cancer information is coded using the International Classification of Disease for Oncology (ICD-O), 2nd edition

follows data standards of the North American Association of Central Cancer Registries (NAACCR)

participates in CDC’s National Program of Cancer Registries and NCI’s Surveillance, Epidemiology, and End Results (SEER) program

an active member of NAACCR

New Jersey State Cancer RegistryData Quality

recipient of NAACCR’s Gold Standard (highest possible) for 1995 through 2000 data

Gold Standard is based on:– completeness of case ascertainment – > 95%– missing/unknown age at diagnosis, gender,

county – each < 2%– missing/unknown race - < 3%– death certificate only cases - < 3%– duplicate cases - < 1 per 1000– passing an edit program – > 99% correct– timeliness – data submitted within 24

months

New Jersey Cancer Incidence by County, 1996-2000 – Data Sources

data are from the May, 2003 analytic file tabulations using SEER*Stat, a statistical

software package distributed by NCI 1996-1999 populations estimates from NCI 2000 populations from U.S. Census Bureau

Note: NJSCR follows the SEER multiple primary rules; thus a patient with cancer can be counted more than once if diagnosed with two or more primary cancers.

New Jersey Cancer Incidence by County, 1996-2000 – Hispanic Algorithm

used the NAACCR Hispanic Identification Algorithm (NHIA)

auguments the cases reported as Hispanic based on:

– birthplace– marital status– race– surname match to the 1990 U.S. Census

Hispanic surname list

County Cancer Incidence Tables and Figures – General Information

includes the 7 cancers in the CCCP – breast, cervix, colorectal, lung & bronchus, melanoma, oral cavity & pharynx, prostate

include incidence rates and stage at diagnosis by race, ethnicity, and age group for:– men and women for colorectal, lung & bronchus,

oral cavity & pharynx cancers and melanoma of the skin

– women only for breast, cervical cancer– men only for prostate cancer– except stage at diagnosis is not included for lung

& bronchus cancer

County Cancer Incidence Tables and Figures – General Information (cont.)

incidence rates were calculated for invasive cancers only

incidence rates are per 100,000 population and age-adjusted to the 2000 U.S. population standard

percents diagnosed by stage include invasive and in situ cases except for cervical cancer

for the percents diagnosed by stage the in situ and localized stages are combined except for breast cancer

Note: invasive cancers are localized, regional, and metastatic stages; in situ cancers are not considered invasive

County Cancer Incidence Tables and Figures – General Information (cont.)

race categories are white, black, and all races (includes other than white and black races and unknown race)

ethnic category is Hispanic (non-Hispanic is not shown)

race and ethnicity are not mutually exclusive age groups are 15-39, 40-49, 50-64, 65-74,

75 and over (the 0-14 age group was not included due to very small numbers statewide)

counts, and rates based on counts, fewer than 5 are suppressed due to unreliability

County Tables & GraphsCancer Incidence

use to determine opportunities for prevention activities (and screening activities for colorectal cancer)

within the county compare rates among the different gender, the different race and ethnic groups and the different age groups

compare the county rates to the New Jersey rates

be cautious with rates based on small numbers:– the number of people affected is small– the rates are not reliableNote: Corresponding incidence graphs for

men and women are on the same scale.

County Tables & GraphsCancer Incidence by Race and Ethnicity

table includes incidence counts and rates for each year and 1996-2000 combined

separate table and graphs for each gender where applicable

table includes all races, whites, blacks, Hispanics for the county and New Jersey

first line graph shows annual incidence rates for whites and blacks in the county and New Jersey (if data for blacks is suppressed then all races is shown instead)

second line graph shows annual incidence rates for Hispanics in the county and New Jersey

County Tables & GraphsCancer Incidence by Age Group

separate table and graphs for each gender where applicable (New Jersey is shown separately)

table includes incidence counts and rates for each year and 1996-2000 combined

table includes five age-groups for the county line graph shows annual incidence rates by

age group

County Tables & GraphsStage at Diagnosis

use to determine screening needs – distant stage is the most important stage to note

within the county compare percent diagnosed at the distant stage among the different race and ethnic groups and the different age groups

compare the percent diagnosed at the distant stage in the county with New Jersey

be cautious with percents based on small numbers:– the number of people affected is small– the percents are not reliable

County Tables & GraphsStage at Diagnosis by Race and Ethnicity

separate table and charts for each gender where applicable (New Jersey is shown separately)

table includes the number and percent of cases diagnosed at each stage for 1996-2000 combined

table includes all races, whites, blacks, Hispanics for the county

pie charts show the percent diagnosed by stage for all races, whites, blacks, and Hispanics

the dark pie slice is the distant stage, the stage with the lowest survival rate

Note: Read the pie chart clockwise.

County Tables & GraphsStage at Diagnosis by Age Group

separate tables and graphs for each gender where applicable (New Jersey is shown separately)

table includes the number and percent of cases diagnosed at each stage for 1996-2000 combined

table includes five age-groups for the county (New Jersey is shown separately)

pie charts show the percent diagnosed by stage for each age group

the dark pie slice is the distant stage, the stage with the lowest survival rate

Note: Read the pie chart clockwise.

County Tables & GraphsComparison with Other Data Sources

Healthy New Jersey 2010:– this county data is more recent– age-adjusted rates computed using the

1970 U.S. population standard so cannot compare with these county data rates*

Cancer Control Planet:– this county data is more recent– Planet suppresses counts <16– Planet does not include stage at diagnosis

*Currently, the 2000 U.S. population standard is used nationwide.

County Tables & GraphsGroup Exercise

three groups (by color of your folder) each group has one cancer type for one

county discuss the data (e.g. compare incidence and

stage at diagnosis among the genders, races, ethnicity and with New Jersey)

agree upon two or three prevention/early detection activities and the target population(s) for each based on the data

if time enough, each group report its findings